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Multiple sclerosis (MS) patients often present hyper-intense T2-w lesions in the spinal cord. The severe imbalance between background and lesion classes poses a major challenge to Deep Learning segmentation approaches, requiring for ad hoc strategies. Careful selection of the loss function and adjustment of the conventional 0.5-thresholding may help mitigating this issue. Our results show the performance advantages of loss functions based on the Tversky Index and the benefits of threshold tuning over more standard settings and the state-of-the-art model for MS lesion segmentation on spinal cord MRI.